There’s no denying that Douglas Joseph, … Read More
There’s no denying that Douglas Joseph, … Read More
© 2019 New Hampshire Orthopaedic Center
Each year, roughly 3,000 physicians licensed to practice in New Hampshire are asked to nominate specialists they would most recommend to family and friends. Those selected as ‘Top Doctors’ received the greatest number of recommendations within 45 specialties. New Hampshire Orthopaedic Center physicians have been voted ‘Top Doctors’ in New Hampshire Magazine 32 times since 2001-more than any other orthopaedic group in the state.
The votes for 2018 have been counted and seven New Hampshire
Orthopaedic Center physicians have been included in the Top Doctor listing:
Eric R. Benson, MD – Top Doctor for Orthopaedic Surgery
James C. Vailas, MD – Top Doctor for Orthopaedic Surgery
Gregory W. Soghikian, MD – Top Doctor for Orthopaedic Surgery
Robert J. Heaps, MD – Top Doctor for Hand Surgery
Jinsong Wang, MD, PhD – Top Doctor for Hand Surgery
Douglas M. Joseph, MD – Top Doctor for Orthopaedic Surgery
Marc J. Michaud, MD – Top Doctor for Orthopaedic Surgery
Congratulations to all those voted ‘Top Doctors’ for 2018.
These days, some veterans struggle to get any medical care at all, let alone the quality of care that they need in order to live healthy and productive lives. According to the Boston Globe, 25,000 veterans visit the Manchester VA hospital for outpatient care and surgery each year, and some of them wait months just to see a doctor.
To see if you or a veteran you know is eligible for treatment from New Hampshire Orthopedic Center, call 603.883.0091 today.
The first step towards managing joint pain is understanding it. Join Dr. Kathleen Hogan for her free and informative seminar, “Taking Control of your Joint Pain.” Taking place on Thursday, June 8, 2017 from 2:00 – 3:00 PM, the seminar will cover topics including arthritis of the hip and knee, as well as non-surgical and surgical treatment alternatives.
Space is limited, so call 603-672-5037 or email Cindy@ledgewoodbay.com to register today!
by: Kathleen A. Hogan, MD
When knee and hip replacements were first developed most patients would stay in the hospital for a minimum of a week, sometimes longer. This lengthy hospital stay was felt to be necessary for patients to get the physical therapy and the care they required for a full recovery. Today, this has changed. Most patients do not need to go to a nursing home for further rehabilitation and are able to return directly home after surgery. Most stay only 1-2 nights in the hospital, and some patients can actually go home the day of surgery.
Certainly if a patient has diabetes, cardiac disease, kidney problems, sleep apnea or COPD it is important to be monitored closely for the first few days after surgery to ensure that there are no medical complications following surgery. But, what about someone without any of these medical problems? Do they need to stay in the hospital just for physical therapy? In the hospital, physical therapists work with joint replacement patients only once or twice a day. This could certainly be done at home.
Many people prefer the comforts of home to the sterile conditions of a hospital. While at the hospital, you may be exposed to patients who are sick with the flu or other illnesses. Bacteria found in hospitals is often resistant to many antibiotics. Nurses wake you up to check on you at night and control when you receive medication. Nurses will take care of several patients and may not be available immediately. Most common post-operative problems such as swelling, wound drainage, blood clots can be managed by your surgeon in the office if they occur. Hospital care is also very expensive; hospital and implant costs make up the majority of your bill.
Hip and knee replacements can be painful. Improved pain control with the use of long lasting nerve blocks, multimodal pain management, and intra-articular injections can reduce that pain to a manageable level with oral narcotics. Rotator cuff repair and ACL reconstruction are also painful procedures that used to require a short stay in the hospital but are now outpatient surgeries.
Outpatient hip and knee surgeries are performed at a surgical center, not at the hospital. Many patients are ready to go home later that day. They can also stay overnight for observation and go home the next morning. Nurses teach patients how to use crutches or a walker. One nurse is assigned to a maximum of two patients. Physical therapists visit patients at home until they can travel to a therapy office. The surgeon is available for the patient to call if there are any questions or problems at home.
Not every patient is a candidate for an outpatient hip or knee replacement. However, there is no need for lengthy hospital stays for healthy patients after joint replacement. For carefully selected patients, home Yixing Teapots can be a safer and more comfortable place to recover after surgery than the hospital.
by: Kathleen A. Hogan, MD
Hip and knee replacements first began being performed in the United States in the early 1970’s. They are now considered to be one of the most common and most successful orthopedic operations. Over a million joint replacements are performed each year, and it is estimated that over 7 million people in the United States are currently living with artificial hips or knees. This is approximately two percent of the population of this country! The prevalence of joint replacement increases with age. It is estimated that of people over the age of 80, ten percent have had knee replacements and five percent have had hip replacements.
Bilateral arthritis is fairly common. This makes sense as the same factors which increase the risk of arthritis (with the exception of injuries) affect both sides equally. For example, a body mass index greater than 35 increases the risk of developing knee arthritis by four and a half times. This should affect both right and left sides equally. One study of patients undergoing joint replacement found an incidence of radiographic arthritis in bilateral joints in over 80 percent of patients.
Patients often ask what the odds are of needing to have a second joint replaced. One recent study found that after a hip replacement, almost 30 percent of patients had their contralateral hip replaced within 20 years. After a knee replacement, 45 percent had the contralateral knee replaced. However, the risk of having a hip replacement following a knee replacement (or vice versa) was much lower, only two to six percent.
Most people with arthritis in multiple different joints have a systemic cause of their arthritis, such as rheumatoid arthritis (RA). In the past, patients with RA often had severe, crippling deformities with debilitating arthritis of several joints. Joint replacements miraculously restored mobility to patients who were often wheelchair dependent. Many of these patients required both hip and knee replacements. Today, medications have drastically reduced severity of arthritis in patients with RA. It is now somewhat unusual to see severe, untreated rheumatoid arthritis except in third world countries.
Consequentially, it is now also somewhat rare to see a patient who requires replacement of both hips and both knees. Although it has been estimated that eight and a half percent of patients with joint replacements have had at least one hip and one knee replaced, there is no data on the number of patients having both hips and both knees replaced. For those patients who do require quadruple joint replacements, surgery can restore mobility and function and drastically improve the quality of their life.